Pharmacy in the FIELD!!
This is a very important aspect of field trips. Often times you may be fortunate and have a pharmacist come along on the trip. A couple of pre-trip rules I have learned when it comes to this aspect of the operation…
1. Have someone in charge of pharmacy well before the trip. This person should be responsible for generating a master list of what medications are being brought on the trip. The list should be updated weekly and distributed to the entire team. Often different group members can bring different meds, and if there is an identified shortage on one, this can be addressed.
2. Keep in mind that just about any medication is needed. You will be surprised how much tylenol and motrin can help in certain areas. If you have any excess meds lying around that are not expired, bring them. Someone out there could benefit from them, I promise!
3. If you are looking for places to donate meds, there are plenty of places that may be willing as long as you present it in an organized and effective way. Show them a pamphlet or brochure identifying your mission and express your passion for your mission. Walmart, local pharmacies like Walgreens, etc. might be willing to help. We recently received a $200 donation from Walmart by simply showing them a mission brochure. If they do donate, bring them back a photo showing your work in the field. This is a great way of saying thank you. (You may want them to contribute again on another one of your missions!)
4. There are organizations/agencies that can help supply you with meds for these types of relief trips. I will soon be providing this list in a section on the site.
5. You can never bring too much of any medication…better more than less in the field!
6. Commonly used and most distributed meds: motrin, tylenol, cimetidine, multivitamins, meclizine, raglan, antidiarrheals, lotrimin, diflucan, albendazole, mebendazole, prednisone, albuterol, anti-hypertensives, flail, amoxicillin, cipro, kefex, ancef, acyclovir, aspirin, metformin…just to name a few off the top of my head!
7. Make sure and clarify with your trip coordinator what type of meds to bring to the field, for example, IV meds vs. oral meds only.
IV meds and fluids can take up a little more space and weigh more than oral meds. Make sure you will be allowed and able to use IV meds in the field…otherwise they may go to waste and cost you more money to fly over.
8. Make a final check of the master pharmacy list prior to departure. Identify med shortages and make one last ditch effort to collect what you can! Make sure the physicians, PA, and NPs all have a master list prior to leaving. Too many times I have not had a list, and items I could have found before leaving home did not get supplied for the trip!
9. Be prepared to show these meds when arriving at Customs. Have a master list, smile a lot, and tell them what you are there to do.They usually won’t make a big issue of this, but it has occurred before.
Field operations and Pharmacy!!
Day 1 of clinic operations…BE PREPARED FOR CHAOS! This always seems to be the case of relief operations that require a setup. If you are in a hospital or town clinic then you need not worry about this. Setting up pharmacy can be quite tedious as all the meds need to be distributed in small packets written in the native language CLEARLY AND SIMPLY!! This can take hours to do, and you will often find yourself working late into the night after clinic days to reorganize the pharmacy for the next day. It’s a work-in-progress indeed!
1. Rule number one – Have one person in charge, not several.
2. Don’t forget to bring many small plastic packets and a felt tip marker for writing instructions on meds.
3. When a patient approaches to pick up a medication, take your time with them. Do not rush things and just give them the medication. Assume, rightfully so, that they do NOT understand how to take the meds. Explain precisely how to take the medication. Otherwise, you may have them taking an antibiotic the wrong way and taking the pen med every 4 hours. I cannot stress this enough!! WAY TOO OFTEN, PATIENTS LEAVE THE PHARMACY CONFUSED!! Have them go through the instructions verbally with you after you explain them to them!
4. Help the pharmacy with cleanup at the end of the day. They are often the last part of clinic to break down at days end and will be working late into the night to reorganize.
5. If you have the supplies and there is a high incidence of parasite, DEWORM everyone. Also, give vitamins to everyone as well… iron supplements along with b12 and folate are good options as well.
6. If you have the supply to do so, give everyone a small supply of motrin and tylenol. Everyone has aches and pains from time to time that could benefit from one or both of these.
7. You may find out that by the end of the trip, you are short of needed meds. Try and keep this in mind all week so the folks you see on the last day don’t end up shorthanded. Unfortunately, this occurs all too often.
8. Prior to the end of the trip, make arrangements to leave any extra medications with a organization that can get them to the right people.